• D Kothari, A Malik, N Kothari, J Bogra, M Kohli, R S Keshari, M K Barthwal, and M Dikshit.
• Department of Anaesthesia, CSM Medical University, Lucknow, India. madhu_dikshit@cdri.res.in
• Acta Anaesthesiol Scand. 2012 Mar 1;56(3):307-15.

IntroductionActive nitrogen molecules are formed as a result of cell metabolism. They are essential for cell metabolism, but when produced in excess, they contribute to the pathogenesis of several disease processes. These nitrogen molecules play an important role in vascular instability of septic shock. This study was planned to detect the role of active nitrogen molecules in the progression of septic shock.Materials And MethodsBlood samples were collected from 118 critically ill patients admitted in ICU and from 95 healthy relatives accompanying the patients. Patients were categorized into three groups: systemic inflammatory response syndrome (n = 54), sepsis (n = 35) and septic shock (n = 29). Plasma total nitrite (nitrites and nitrates), cytokines like tumour necrosis factor-α (TNF-α) and plasma lactate were measured to assess inflammatory activity and severity of septic shock.ResultsHigh plasma levels of nitrite and nitrate (No₂-/No₃-) were observed in critically ill patients (mean level 78.92 μmol/l in sepsis and 97.20 μmol/l in septic shock). Mean plasma TNF-α level in sepsis was 213.50 pg/ml and septic shock was 227.38 pg/ml.ConclusionPlasma No₂-/No₃- and TNF-α levels were high in patients with sepsis and septic shock, which increased with severity of sepsis.© 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

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